DR. TIMOTHY W BOERSMA DO NPI 1942244926

NPI Information

NPI: 1942244926
Provider Name: DR. TIMOTHY W BOERSMA, DO
Classification: General Practice - 208D00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
175 S UNION BLVD STE 350
COLORADO SPRINGS, CO
ZIP 80910
Phone: (719) 633-5515
Get Directions

DR. Timothy W Boersma, DO is a general practice in Colorado Springs, CO. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee DR. Timothy W Boersma, DO NPI is 1942244926. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

175 S UNION BLVD STE 350
COLORADO SPRINGS, CO
ZIP 80910-146
Phone: (719) 633-5515
Fax: (719) 365-1307

The NPI 1942244926 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/16/2006 and was last updated on 9/2/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	207P00000X	Emergency Medicine	036126968	ILLINOIS	No
2	207Q00000X	Family Medicine	DR.0061598	COLORADO	No
3	207Q00000X	Family Medicine	F3766	TEXAS	No
4	207Q00000X	Family Medicine	036126968	ILLINOIS	No
5	208D00000X	General Practice	DR.0061598	COLORADO	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	113686306	MEDICAID	TEXAS
2	1136863	MEDICAID	TEXAS
3	75-2616977-066	OTHER	TEXAS	TRICARE
4	8DZ891	OTHER	TEXAS	BCBS
5	8F5719	OTHER	TEXAS	BCBS
6	9000173087	MEDICAID	COLORADO
7	113686305	MEDICAID	TEXAS
8	P01092668	OTHER	TEXAS	RAIL ROAD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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